WO2017038931A1

WO2017038931A1 - Vitreous body cutter

Info

Publication number: WO2017038931A1
Application number: PCT/JP2016/075637
Authority: WO
Inventors: 悦男村上
Original assignee: マニー株式会社
Priority date: 2015-09-01
Filing date: 2016-09-01
Publication date: 2017-03-09
Also published as: JP2017046876A; US20180243133A1; EP3332756A1; EP3332756B1; EP3332756A4; JP6553990B2; US10675181B2

Abstract

Provided is a vitreous body cutter that has a tip that has an opening that can be moved a large amount, even if a pipe is narrow, and that makes it possible to suction a wide range of vitreous bodies, etc. A vitreous body cutter (10) that has: a pipe (20) that has an opening (21) provided in a tip side surface thereof; a cutter (30) that slides along an inner surface of the pipe (20); a motive power part (25) that is connected to the pipe (20) and that makes the cutter (30) slide; and an outer case (40) that has the pipe (20) inserted therethrough and that has the motive power part (25) provided to the inside thereof. The outer case (40) has a connection part (41) that connects to a cannula (50), which is mounted on an eyeball (60), such that the outer case becomes integrated with the cannula. The amount that the pipe (20) protrudes from the outer case (40) may be alterable.

Description

Vitreous cutter

The present invention relates to a vitreous cutter used for ophthalmic surgery.

A vitreous cutter used in ophthalmic surgery is for cutting and removing a jelly-like vitreous body in the eyeball and a proliferative membrane on the retina (hereinafter referred to as a vitreous body) formed by degeneration of the vitreous body. Used. Patent Document 1 describes the structure of the tip of such a vitreous cutter (probe for vitreous surgery). FIG. 5 is a cross-sectional view of the tip of the vitreous cutter.

The vitreous cutter has a pipe 20 sealed at the tip, and a cutter 30 slidable in the axial direction of the pipe 20 while being in contact with the inner surface of the pipe 20. An opening 21 is provided on the side surface near the tip of the pipe 20, and the vitreous body 65 is sucked therefrom. At this time, the cutter 30 slides inside the pipe 20, and when the tip of the cutter 30 passes through the opening 21, the vitreous body 65 is cut. It is the structure which is attracted | sucked and collect | recovered (right direction of FIG. 5).

Such a vitreous cutter is used by inserting a pipe into a cannula inserted into the eyeball. At that time, when the pipe diameter of the vitreous cutter is small, even if the opening position of the pipe tip is moved, the pipe bends outside the cannula and it is difficult to move the opening position greatly in the eyeball. However, since the vitreous cutter is used for intraocular surgery, it is preferable that the pipe diameter is small. In particular, a 27 gauge (0.4 mm) pipe may be used recently, and such a thin vitreous cutter has a particularly low rigidity. Therefore, when performing an operation, it is necessary to operate without moving the eyeball. I'm about to tell you.

However, if the pipe is not moved greatly and the eyeball is not moved, the range in which the vitreous body can be sucked is limited. This increases the possibility of vitreous body remaining in the eyeball. Therefore, even if the vitreous cutter pipe is thin, it is desirable to operate by moving the vitreous cutter or eyeball freely.

JP 2014-42703 A

In view of such circumstances, an object of the present invention is to provide a vitreous cutter that can move the opening position of the tip greatly even when the pipe is thin and can suck a vitreous body in a wide range.

The vitreous cutter of the present invention includes a pipe having an opening on the side surface of the tip, a cutter that slides along the inner surface of the pipe, a power unit that is connected to the pipe and slides the cutter, and a pipe that penetrates the power unit. A vitreous cutter having an outer case provided therein, and the outer case has a connecting portion that is connected so as to be integrated with a cannula attached to the eyeball.

Also, it is preferable that the pipe, the cutter and the power unit can move back and forth in the axial direction of the pipe with respect to the outer case, and the amount of protrusion of the pipe from the outer case can be changed.

According to the present invention, since the vitreous cutter and the cannula can be integrated, even when the pipe is thin, the range in which the opening of the pipe can be moved within the eyeball is wide, and the range in which the vitreous can be sucked There is an effect that it can be widened.

In addition, by making the projecting amount of the pipe from the outer case freely changeable, the vitreous body near the front of the eyeball can be sucked while being integrated with the cannula.

BRIEF DESCRIPTION OF THE DRAWINGS It is an external view of the vitreous cutter of this invention, (a) shows the condition before connecting to a cannula, (b) shows the condition after connecting to a cannula. It is a figure which shows the movement range of opening when a pipe is thin, Comprising: (a) shows the conventional vitreous cutter, (b) shows the vitreous cutter of this invention. It is sectional drawing which shows the internal structure of the vitreous cutter of this invention, Comprising: (a) shows the case where the protrusion amount of a pipe is large, (b) shows the case where the protrusion amount of a pipe is made small. It is a figure which shows the movement range of the opening of this invention, Comprising: (a) shows the case where the protrusion amount of a pipe is large, (b) shows the case where the protrusion amount of a pipe is made small. It is sectional drawing of the front-end | tip part of a vitreous cutter.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings.

FIG. 1 is an external view of the vitreous cutter of the present invention, where (a) shows the situation before connection to the cannula, and (b) shows the situation after connection to the cannula. The vitreous cutter 10 inserts the pipe 20 of the vitreous cutter 10 into a cannula 50 pierced into the eyeball 60 and sucks the vitreous body and the like in the eyeball 60.

In the vitreous cutter 10, the pipe 20 protrudes through the outer case 40, the tip of the pipe 20 is sealed, and an opening 21 for sucking vitreous or the like is opened on the side of the tip. A power unit connected from the pipe 20 is built in the outer case 40, and the cutter 30 is slid along the inner surface of the pipe 20 by the power unit. The method for collecting the vitreous body is the same as described above, and the cutter 30 slides on the inner surface of the pipe 20 so that the vitreous body sucked from the opening 21 is cut into small pieces and sucked into the back side of the pipe 20. Yes.

The cannula 50 includes a tubular main body 51 that penetrates the eyeball 60 and a base 52 that serves as a stopper. As shown in FIG. 1A, the pipe 20 of the vitreous cutter 10 is inserted into the main body 51 of the cannula 50 attached to the eyeball 60 to obtain the state shown in FIG. At this time, the vitreous cutter 10 and the cannula 50 are integrated by the convex connection part 41 provided in the outer case 40 being united with the base part 52 of the cannula 50. In addition, the connection method of the outer case 40 and the cannula 50 is not particularly limited, and the cannula 50 and the pipe 20 may be connected to move integrally when the outer case 40 is moved in a connected state. That's fine.

Next, the effect of integrating the vitreous cutter 10 and the cannula 50 in this way will be described. 2A and 2B are diagrams showing the moving range of the opening when the pipe is thin, in which FIG. 2A shows a conventional vitreous cutter, and FIG. 2B shows the vitreous cutter of the present invention.

In FIG. 2A, the vitreous cutter 10 and the cannula 50 are not integrated, and since the pipe 20 is thin, the pipe 20 bends at a position 20a outside the cannula 50 when the outer case 40 is moved. become. Then, the pipe 20 cannot be moved greatly within the eyeball.

Therefore, if the vitreous cutter 10 and the cannula 50 are integrated as shown in FIG. 2B, the cannula 50 and the pipe 20 move at the same angle as the outer case 40 when the outer case 40 is moved. The opening 21 provided at the tip of the can be moved greatly.

However, when the vitreous cutter 10 and the cannula 50 are integrated, the cannula 50 must not come out of the eyeball 60, and therefore, the movement of the outer case 40 in the front-rear direction (direction approaching or moving away from the eyeball) is restricted. . Then, since the opening 21 can be moved only at a certain depth position of the eyeball 60, the protruding amount of the pipe 20 can be adjusted so that the piercing depth can be changed. .

FIG. 3 is a cross-sectional view showing the internal structure of the vitreous cutter of the present invention, where (a) shows a case where the protruding amount of the pipe is large, and (b) shows a case where the protruding amount of the pipe is reduced. Here, a state where the cannula 50 and the vitreous cutter 10 are integrated is illustrated. For the protrusion amount L from the outer case 40, FIG. 3A illustrates the maximum protrusion amount Lmax, and FIG. 3B illustrates the minimum protrusion amount Lmin.

Here, since the pipe 20, the cutter 30, and the power unit 25 are integrally coupled, the adjustment of the protrusion amount L can be performed by moving the power unit 25 built in the outer case 40 in the front-rear direction with respect to the outer case 40. This can be done by moving it.

Although how to move the power unit 25 is not particularly limited, in the example shown in FIG. 3, a protrusion amount adjusting tool 26 connected to the power unit 25 is provided through the outer case 40. The amount of protrusion L is changed by moving the pipe back and forth in the axial direction of the pipe 20.

4A and 4B are diagrams showing the movement range of the opening of the present invention, where FIG. 4A shows a case where the protruding amount of the pipe is large, and FIG. 4B shows a case where the protruding amount of the pipe is reduced. A range indicated by a broken line is a movement range of the opening 21.

When the protruding amount is increased, the vitreous body or the like at a deep position of the eyeball 60 can be sucked as shown in FIG. Here, if the cannula 50 and the vitreous cutter 10 are integrated and the projecting amount of the pipe 20 cannot be changed, the vitreous body on the near side of the eyeball 60 is sucked unless the cannula 50 is removed from the eyeball 60. Is difficult. However, in the present invention, since the amount of protrusion of the pipe 20 can be changed, the vitreous body or the like on the near side of the eyeball 60 is sucked by reducing the amount of protrusion without removing the cannula 50 from the eyeball 60. It becomes possible.

As described above, according to the present invention, by integrating the cannula and the vitreous cutter, the opening position can be moved greatly even when the pipe is thin, and the protrusion amount of the pipe can be adjusted. In addition, the vitreous body and the like can be sucked over the entire eyeball.

DESCRIPTION OF SYMBOLS 10 Vitreous cutter 20 Pipe 21 Opening 25 Power part 26 Projection amount adjustment tool 30 Cutter 40 Outer case 41 Connection part 50 Cannula 51 Main part 52 Base part 60 Eyeball 65 Vitreous body etc.

Claims

A pipe having an opening on the side surface of the tip, a cutter that slides along the inner surface of the pipe, a power unit that is connected to the pipe and that slides the cutter, and an outer that penetrates the pipe and includes the power unit therein A vitreous cutter having a case,
A vitreous cutter, characterized in that the outer case has a connecting portion to be connected to a cannula attached to an eyeball.
2. The pipe, the cutter, and the power unit can move back and forth in the axial direction of the pipe with respect to the outer case, and a protruding amount of the pipe from the outer case is freely changeable. The vitreous cutter described in 1.